It was not me: attribution of blame for criminal acts in psychiatric offenders.

The current article addresses the psychometric qualities of the German Version of Gudjonsson's Blame Attribution Inventory (GBAI), a self-report scale for measuring attribution of blame for crime. The GBAI was administered to a criminal sample of forensic and criminal inmates (n=107). Findings indicate that the German version of the Gudjonsson Blame Attribution Inventory possesses acceptable test-retest stability and good internal consistency. Factor analysis reproduced the three basic dimensions of the GBAI: external attribution, mental-element attribution, and guilt-feeling attribution. Forensic patients had higher mental-element attribution and guilt-feeling attribution scores than the prison inmates. Interestingly, sexual offenders who were prisoners, showed the lowest guilt-feeling attribution, while sexual offenders who were forensic patients had the highest guilt-feeling attribution scores. Since earlier research reported a tendency of faking good in sexual offenders, we suggest that the forensic sexual offenders may demonstrate a social desirable response tendency in an attempt to gain sympathy and/or earlier parole. All in all, our data show that the German version of the GBAI is a valuable tool for measuring attributional styles of offenders.

[The connection between trauma and dissociation: a critical evaluation]. / Der Zusammenhang zwischen Trauma und Dissoziation: Eine kritische Betrachtung.

Dissociation is often considered to be a psychological defense mechanism used by victims of traumatic events (e. g., sexual abuse, physical punishment, or emotional abuse). Evidence for this view comes from studies that found a connection between self-reported traumatic childhood experiences and high levels of dissociation. However, there are some problems with this causal interpretation. The aim of this review is to summarize evidence that casts doubts on the commonly voiced view that the connection between self-reported trauma and dissociation is a simple and robust one. First, we briefly summarize studies that looked at the link between trauma and dissociation as well as studies that identified factors that may modulate this link. Second, we review studies that explored the psychological correlates of dissociation. Over the past few years, our knowledge of these correlates has increased considerably. Some of these correlates (e. g., fantasy proneness, suggestibility, and frontal lobe dysfunction) are especially relevant because they may undermine the accuracy of retrospective self-reports of trauma. Finally, we conclude that the link between trauma and dissociation is more complex than many clinicians seem to assume. In particular, the possibility that dissociation acts as an antecedent of self-reported trauma warrants serious attention.

[The German version of the Structured Inventory of Malingered Symptomatology: SIMS]. / "Strukturierter Fragebogen Simulierter Symptome". Die deutsche Version des "Structured Inventory of Malingered Symptomatology: SIMS"

The current article addresses the psychometric qualities of the German version of the Structured Inventory of Malingered Symptomatology (SIMS), a self-report measure of malingering. The SIMS was administered to a heterogeneous sample of forensic patients (n=62) and undergraduate students (n=204). Within the student sample, some undergraduates were instructed to feign certain pathological conditions, while others were asked to respond honestly to the SIMS items. The findings indicate that the German version of the SIMS demonstrates adequate test-retest stability and internal consistency. In the patient sample, the SIMS was found to correlate strongly with manipulative and antisocial personality features. More specifically, SIMS scores were higher in sexually delinquent patients with antisocial personality disorders. Our findings support the SIMS as a valuable screening tool for malingering of psychiatric symptoms.

Repair of pectus excavatum deformities in children: a new perspective of treatment using minimal access surgical technique.

HYPOTHESIS: Minimally invasive correction of pectus excavatum (PE) deformities of the anterior chest wall in children is safe and effective. DESIGN: Prospective cohort study. SETTING: Tertiary pediatric referral center. PATIENTS: Between February 1996 and July 2000, 36 patients underwent minimally invasive repair (MIR) of PE deformities, and 6 patients had traditional Ravitch repairs (RR). MAIN OUTCOME MEASURES: Morbidity, operating time, estimated blood loss, days to tolerating a regular diet, and length of hospital stay. RESULTS: Thirty-six children underwent MIR for moderate to severe chest wall deformities, with a mean operative time of 1.6 hours, a mean blood loss of 22 mL, a mean time to tolerating a regular diet of 2.9 days, no intensive care unit admissions, and a mean length of hospital stay of 5.5 days. Six children had RR procedures performed for moderate to severe deformity, with a mean operative time of 5.2 hours, a mean blood loss of 222 mL, a mean time to tolerating a regular diet of 3.3 days, 2 patients admitted to the intensive care unit, and a mean length of hospital stay of 4.5 days. Complications for both procedures consisted mainly of postoperative pneumothorax. CONCLUSIONS: The MIR technique for PE is less invasive, less morbid, and better tolerated than traditional open RR of this common pediatric chest wall deformity. Elective surgical reconstruction can be safely performed in children rather than limiting repair to only symptomatic patients with severe deformities.

[Follow-up studies of gerontopsychiatric long-term patients following a change in residential status]. / Verlaufsbeobachtungen von gerontopsychiatrischen Langzeitpatienten nach Anderung der Wohnsituation.

Changes in living conditions of the elderly are considered as critical life events. The degree of stress produced by such critical life events is seen largely dependent on controllability and predictability of the situation. Our study focuses on changes in behavior and well-being at four times during ten weeks while 34 long-term gerontopsychiatric patients moved into reconstructed wards, which were mainly improved under ecological aspects. Investigations were performed with the "Beobachtungsskala für alternde Patienten (BAP)" and by free observation. In summary, the results show reduced well-being and behavioral problems at all four times of measurement for female patients compared to the male group. In contrary, for male patients there is a significant reduction in need of help, physical disability, aggression and depression one week after the move. But these improvements are not stable. Partly, they are followed by decreases even beyond the baseline six weeks after the move. Therefore, unlike the male patients it seems that the older and more impaired women in our sample can not at all profit from the positive changes in the new living conditions on the ward at any time during our study. Their well-being remains obviously unsatisfactory and becomes even worse and threatening for single cases after the move. Results are discussed with respect to psychiatric impairments like dementia, paranoia, with regard to stress and coping as well as with respect to some contradictory findings in this field of research.